<div class="col-lg-12">
	<!--当前位置 start-->
	<div class="row">
		<div class="col-lg-12">
			<ol class="breadcrumb">
				<li><i class="fa fa-home mrg-r-sm"></i>首页
				</li>
				<li class="active"><span>新增评估报告</span>
				</li>
			</ol>
		</div>
	</div>
	<!--当前位置 end-->

	<!--代码写在这里-->
    <style>
        .form-group{
            width: 33%;
            float: left;
        }
        .control-label{width: 90px;}
        .col-lg-6{ width: 65%;}
    </style>
	<div class="row">

		<div class="col-lg-12">
			<div class="main-box">
				<header class="main-box-header clearfix">
					<h2>基本信息</h2>
				</header>
				<div class="main-box-body clearfix">
					<form class="form-horizontal" role="form">
						<div class="form-group">
							<label class="col-lg-2 control-label">姓名</label>
							<div class="col-lg-6">
								<input type="text" class="form-control" ng-model="archives.name" placeholder="请输入姓名">
								<input type="hidden" ng-model="archives.code">
							</div>
						</div>
						<div class="form-group">
							<label class="col-lg-2 control-label">性别</label>
							<div class="col-lg-6">
								<select class="form-control" ng-model="archives.sex">
                                    <option value="">请选择</option>
									<option ng-selected="archives.sex == '女'" value="女">女</option>
									<option ng-selected="archives.sex == '男'" value="男">男</option>
								</select>
							</div>
						</div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">年龄</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.old" placeholder="请输入年龄">
                            </div>
                        </div>
						<div class="form-group">
							<label class="col-lg-2 control-label">出生年月</label>
							<div class="col-lg-6">
								<input type="text" class="form-control " id="birthday" onclick="laydate()" ng-model="archives.birthday" data-date-format="yyyy-mm-dd" placeholder="请输入出生年月，如:1970-03">
							</div>
						</div>
						<div class="form-group">
							<label class="col-lg-2 control-label">行政区 </label>
							<div class="col-lg-6">
	                            <select class="form-control" ng-model="archives.xingzheng_code" ng-change="getStreet(archives.xingzheng_code)"  ng-options="rgn.code as rgn.title for rgn in (region|filter:{code:'20030916001594'})" >
									<option value="">请选择</option>
								</select>
							</div>
						</div>
						<div class="form-group">
							<label class="col-lg-2 control-label">街道</label>
							<div class="col-lg-6">
	                            <select class="form-control"  ng-model='archives.jiedao_code' ng-change="getArea(archives.jiedao_code)" ng-options=" str.code as str.title for str in streets" >
									<option value="">请选择街道</option>
								</select>
							</div>
						</div>
						<div class="form-group">
							<label class="col-lg-2 control-label">社区</label>
							<div class="col-lg-6">
								<select id="shequ" name="shequ" class="form-control"  ng-model='archives.shequ_code' ng-options="ar.code as ar.title for ar in areas">
                            	    <option value="">请选择社区</option>
								</select>
							</div>
						</div>
						<div class="form-group">
							<label class="col-lg-2 control-label">详细居住地址</label>
							<div class="col-lg-6">
								<input type="text" class="form-control" ng-model="archives.address" placeholder="请输入详细居住地址">
							</div>
						</div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">联系电话</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.phone_mob" placeholder="请输入联系电话">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">住宅电话</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.phone_home" placeholder="请输入住宅电话">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">文化程度</label>
                            <div class="col-lg-6">
                                <select id="education" name="shequ" class="form-control"  ng-model='archives.attribute.education'>
                                    <option value="">请选择文化程度</option>
                                    <option value="博士">博士</option>
                                    <option value="硕士">硕士</option>
                                    <option value="本科">本科</option>
                                    <option value="大专">大专</option>
                                    <option value="高中">高中</option>
                                    <option value="初中">初中</option>
                                    <option value="小学">小学</option>
                                    <option value="其他">其他</option>
                                </select>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">宗教信仰</label>
                            <div class="col-lg-6">
                                <select id="sect" name="sect" class="form-control"  ng-model='archives.attribute.sect'>
                                    <option value="">请选择宗教信仰</option>
                                    <option value="无教派">无教派</option>
                                    <option value="佛教">佛教</option>
                                    <option value="基督教">基督教</option>
                                    <option value="天主教">天主教</option>
                                    <option value="伊斯兰教">伊斯兰教</option>
                                </select>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">医保卡号</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.medicare" placeholder="请输入医保卡号">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">是否独居</label>
                            <div class="col-lg-6">
                                <select id="alone" name="alone" class="form-control"  ng-model='archives.attribute.alone'>
                                    <option value="">前选择</option>
                                    <option  value="是">是</option>
                                    <option  value="否">否</option>
                                </select>
                            </div>
                        </div>
						<div class="form-group">
							<label class="col-lg-2 control-label">身份证号</label>
							<div class="col-lg-6">
								<input type="text" class="form-control" ng-model="archives.cardid" placeholder="请输入身份证号">
							</div>
						</div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">籍贯信息</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.homeTown" placeholder="请输入籍贯">
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">备注</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.description" class="form-control"></textarea>
                            </div>
                        </div>
					</form>
				</div>
			</div>
            <div class="main-box">
                <header class="main-box-header clearfix">
                    <h2>健康信息</h2>
                </header>
                <div class="main-box-body clearfix">
                    <form class="form-horizontal" role="form">
                        <div class="form-group">
                            <label class="col-lg-2 control-label">身高</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.height" placeholder="请输入身高">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">体重</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.weight" placeholder="请输入体重">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">血压(高压)</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.high_handed" placeholder="请输入高压">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">血压(低压)</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.low_handed" placeholder="请输入低压">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">心率</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.heart_rate;" placeholder="请输入心率">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">呼吸</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.breathing" placeholder="请输入呼吸">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">体温</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.attribute.temperature" placeholder="请输入体温">
                                <input type="hidden" ng-model="archives.code">
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">既往病史</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.old_his" class="form-control"></textarea>
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">现病史</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.new_his" class="form-control"></textarea>
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">外伤病史</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.hurt_his" class="form-control"></textarea>
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">药物过敏史</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.med_his" class="form-control"></textarea>
                            </div>
                        </div>
                        <div class="form-group" style="width: 100%">
                            <label class="col-lg-2 control-label">目前接受的治疗及护理方案</label>
                            <div class="col-lg-6" style="width: 80%">
                                <textarea ng-model="archives.attribute.nurse" class="form-control"></textarea>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">自理能力评分</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.point" placeholder="请输入自理能力评分">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-lg-2 control-label">自理能力评估</label>
                            <div class="col-lg-6">
                                <input type="text" class="form-control" ng-model="archives.mine_point" placeholder="请输入自理能力评估">
                            </div>
                        </div>

                    </form>
                </div>
            </div>
            <div class="main-box" style="display: none">
                <header class="main-box-header clearfix">
                    <h2>e家养老院评估量表</h2>
                </header>
                <div class="main-box-body clearfix">
                    <form class="form-horizontal" role="form">

                    </form>
                </div>
            </div>
            <div class="main-box" style="display: none">
                <header class="main-box-header clearfix">
                    <h2>家庭状况与特殊需求</h2>
                </header>
                <div class="main-box-body clearfix">

                </div>
            </div>
            <div class="main-box" style="display: none">
                <header class="main-box-header clearfix">
                    <h2>评估附件</h2>
                </header>
                <div class="main-box-body clearfix">
                    <form class="form-horizontal" role="form">

                    </form>
                </div>
            </div>
            <div class="main-box">
                <header class="main-box-header clearfix">
                    <h2>服务计划</h2>
                    <a href="javascript:void(0)" class="btn btn-primary pull-left mrg-b-lg md-trigger" ng-click="addServicePlan()">添加服务计划</a>
                </header>
                <div class="main-box-body clearfix">
                    <div>
                        <table class="table table-hover table-striped text-center" style="width: 90%;">
                            <thead>
                                <tr>
                                    <th class="text-center"><span>下单人</span></th>
                                    <th class="text-center"><span>服务类型</span></th>
                                    <th class="text-center"><span>受理公司</span></th>
                                    <th class="text-center"><span>操作人</span></th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr role="row" class="odd ng-scope" ng-repeat="oList in archivesOrderList">
                                    <td>{{oList.name}}</td>
                                    <td>{{oList.serviceType3_title}}</td>
                                    <td>{{oList.selected_company_name}}</td>
                                    <td>{{oList.record_manager_account}}</td>
                                </tr>
                            </tbody>
                            <tfoot>
                                <tr>
                                    <td colspan="4">
                                    <ul class="pagination pull-right">
                                        <li><a >总条数：{{count}}</a></li>
                                        <li><a >总页数：{{totalPage}}</a></li>
                                        <li><a ng-click="changePage(1)">首页</a></li>
                                        <li><a ng-show="currentPage>1" ng-click="changePage(currentPage-1)"><i class="fa fa-chevron-left"></i></a></li>
                                        <!--<li><span ng-show="frontdotShow">…</span></li>-->
                                        <li ng-repeat="item in pageList" ng-click="changePage(item.number)" class="{{item.active}}"><a>{{item.number}}</a></li>
                                        <!--<li><span ng-show="backdotShow">…</span></li>-->
                                        <li><a ng-show="currentPage<totalPage" ng-click="changePage(currentPage+1)"><i class="fa fa-chevron-right"></i></a></li>
                                        <li><a ng-click="changePage(totalPage)">尾页</a></li>
                                    </ul>
                                    </td>
                                </tr>
                            </tfoot>

                        </table>
                    </div>
                    <div class="main-box-body-basic" ng-show="newPlanTag">
                        <div class="form-group" style="width: 100%; float: left;">
                        <label class="col-lg-2 control-label" style="padding-top: 7px">选择服务类型</label>
                        <div class="col-lg-2">
                            <select class="form-control"  ng-model="order.serviceType1" ng-change="getserviceType2(order.serviceType1.code)" ng-options=" service1 as service1.title for service1 in serviceList1" >
                                <option value="">请选择服务项目</option>
                            </select>
                        </div>
                        <div class="col-lg-2">
                            <select class="form-control"  ng-model="order.serviceType2"  ng-change="getserviceType3(order.serviceType2.code)"  ng-options=" service2 as service2.title for service2 in serviceList2" >
                                <option value="">请选择服务项目</option>
                            </select>
                        </div>
                        <div class="col-lg-2">
                            <select class="form-control"  ng-model="order.serviceType3" ng-change="getFilterCompany(order.serviceType3)"   ng-options=" service3 as service3.title for service3 in serviceList3" >
                                <option value="" >请选择服务项目</option>
                            </select>
                        </div>
                    </div>
                        <div class="form-group" style="width: 100%; float: left;">
                        <label class="col-lg-2 control-label" style="padding-top: 7px">选择受理企业</label>
                        <div class="col-lg-6">
                            <select class="form-control" ng-model="order.selected_company"
                                    ng-options="company as company.name for company in companyList">
                                <option value="">-请选择受理企业-</option>
                            </select>
                        </div>
                    </div>
                        <div class="form-group" style="width: 100%; float: left;">
                        <div class="col-lg-offset-2 col-lg-6">
                            <a class="btn btn-success" id="add-order" ng-click="AddNewPlan(archives,order)">确定</a>
                            <a class="btn btn-danger" href="#/order">取消</a>
                        </div>
                    </div>
                    </div>
                </div>
            </div>
            <div class="main-box-body clearfix">
                <form class="form-horizontal" role="form">
                    <div class="form-group">
                        <div class="col-lg-offset-2 col-lg-6">
                            <a class="btn btn-success" ng-click="edit( archives )">确定</a>
                            <a class="btn btn-danger" href="#/archives">取消</a>
                        </div>
                    </div>
                </form>
            </div>

		</div>
	</div>
</div>
